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A 17-year-old youth was found unconscious in a ditch, lying on his left side, apparently having fallen off his bicycle. The ambulance crew initially attending treated him for a head injury with possible cervical spine injury, and left upper abdominal tenderness raising the possibility of splenic injury. On the basis of putative head, spinal and abdominal injury, air ambulance attendance and transport was requested. On arrival the aircrew found that the patient was fully conscious, and packaged in cervical collar and on a long board. His Glasgow Coma Scale score was 15 and he appeared fully orientated, although he had amnesia of the event. However, he did recall feeling dizzy before the accident. There were no other relevant symptoms, and at the scene he reported no chest pain or shortness of breath. There was no history of alcohol or drug consumption. The airway was self-maintained, breathing was …
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